Florida: The Florida Department of Health in Pinellas County announced Nov. 5 that a positive case of hepatitis A has been identified in a food service worker in St. Pete Beach.

Following lab confirmation on Nov. 1, DOH-Pinellas immediately began conducting an epidemiological investigation and determined the individual worked at Toasted Monkey, 6110 Gulf Blvd., from Oct. 17-28.

DOH says persons who frequented the restaurant on Oct. 17-28, and have not previously been vaccinated for hepatitis A, should be vaccinated. If you have previously received the hepatitis A vaccine you do not need to take additional action. DOH-Pinellas is offering the vaccine at the following locations:

• St. Petersburg, 205 Dr. Martin Luther King Jr. St. N.

• Pinellas Park, 6350 76th Ave. N.

• Mid-County, 8751 Ulmerton Road, Largo.

• Clearwater, 310 N. Myrtle Ave.

• Tarpon Springs, 301 S. Disston Ave.

DOH-Pinellas is encouraging all healthcare providers, including hospital emergency departments to stay on high alert and immediately report cases to the Florida Department of Health.

Ohio: Taco Bell Corporation has confirmed  that an employee at the Elm Road location in Warren has tested positive for hepatitis A. So far there’s only been one confirmed case — but a handful of other employees were showing symptoms.

Taco Bell Corporation issued the following statement:

As soon as the operator of this Warren, Ohio location learned that a team member tested positive for the hepatitis A virus, the franchisee began working immediately with Taco Bell and local health officials. All team members currently working at this restaurant have been offered vaccinations, and the restaurant was thoroughly sanitized.”

Deputy Health Commissioner of the Warren Health District Robert Pinti says he was informed Saturday about an employee testing positive for Hepatitis A.

“Our understanding is eight people were symptomatic having symptoms of Hepatitis A. They’ve received the vaccine also,” Pinti said.

The team member exposed to the virus is on leave and will not return until they are cleared by medical professionals, according to a spokesperson from Taco Bell.

“In this particular case in a restaurant setting, if that food prep handler is doing the right thing and keeping their hands clean, using their gloves, changing their gloves, washing their hands it would be very difficult to pass,” Pinti said.

Taco Bell says all employees working at this location have been offered vaccinations and the restaurant was thoroughly sanitized.

Ohio: People who ate at Cracker Barrel between Oct. 15-21 are being advised to consider getting the hepatitis A vaccine after a food service worker there tested positive for the viral infection.

The Mid-Ohio Valley Health Department made the announcement Monday morning in a joint press release with Cracker Barrel Old Country Store. An assessment by the health department determined the risk of infection was low, the release says.

The Mineral Wells restaurant voluntarily closed late Friday afternoon once test results confirming the employee had tested positive for hepatitis A were received, said Carrie Brainard, public information specialist for the health department. The facility was cleaned and sanitized overnight and reopened early Saturday morning following a health department inspection, she said.

“At Cracker Barrel, nothing is more important to us than the health and well-being of our guests and employees,” Cracker Barrel Old Country Store spokeswoman Heidi Pearce said in the release. “We are also working in collaboration with the Health Department to arrange for a clinic to vaccinate all employees.”

The investigation is related to the multistate outbreak of hepatitis A. An infected worker was reported at the Taco Bell in Belpre this spring.

Brainard said the Cracker Barrel employee is the first case involving a food worker reported in the Mid-Ohio Valley Health Department’s eight-county service area.

“There have been no known cases of hepatitis A being passed from a food worker to a patron” in West Virginia, she said.

Still, the health department recommends people who have not been vaccinated against hepatitis A and ate at the restaurant during the period in question consider getting the vaccine. The release emphasizes this should be done “not more than two weeks from the potential exposure to help prevent infection.”

An employee of Frisch’s located at 1927 Harrodsburg Road has been diagnosed with a confirmed case of hepatitis A.

Customers who ate at the restaurant from Oct. 10-28, 2018, may have been exposed to the hepatitis A virus and are advised to get a hepatitis A vaccination.

Since August 1, 2017, the Kentucky Department for Public Health (DPH) has identified over 2,000 cases of acute hepatitis A, a liver disease caused by hepatitis A virus. An increase in cases since Aug. 1, 2017, primarily among the homeless and drug users, prompted declaration of a statewide outbreak in Nov. 2017. Viral sequencing has linked several outbreak-associated cases in Kentucky with outbreaks in California and Utah.

DPH is working closely with the Centers for Disease Control and Prevention and local health departments to provide guidance and education to health professionals and at-risk populations. Treatment for acute hepatitis A generally involves supportive care, with specific complications treated as appropriate. Hepatitis A is a vaccine-preventable disease. For more information on Kentucky’s hepatitis A outbreak please visit the Hepatitis A Outbreak page.

Counts as of October 20, 2018:

Total Outbreak: 2,275
Hospitalizations: 1209
Deaths: 14

The Florida Department of Health in Pinellas County (DOH-Pinellas) is recommending prevention and vaccination to combat a rise in hepatitis A cases in the county as well as in nearby areas of the state.

As of Oct. 22, 58 cases have been reported in Pinellas and more than 180 in Florida. Similar increases have been reported in other states.

“We are on track to report the highest number of hepatitis A cases since 2005,” said DOH-Pinellas Director Dr. Ulyee Choe. “We have enhanced our public health efforts in encouraging prevention to reduce new cases, but those at risk need to know that there’s an effective vaccine that protects them from this disease.”

As part of its public health mission, DOH-Pinellas is offering the two-dose hepatitis A vaccine at no cost to adults and children. The usual $70.66 cost for adults is waived to remove the barrier of cost; vaccines are always provided at no cost to children and teens through the age of 18. No appointments are needed to get the vaccine at these centers:

• St. Petersburg: 205 Dr. Martin Luther King Jr. St. N.
• Pinellas Park: 6350 76th Ave. N.
• Mid-County (Largo): 8751 Ulmerton Rd.
• Clearwater: 310 N. Myrtle Ave.
• Tarpon Springs: 301 S. Disston Ave.

Hepatitis A is spread person-to-person via feces contaminated with its virus. For example, food prepared by an infected person who doesn’t practice proper hygiene in handwashing could sicken others.

Symptoms include fever, dark urine, yellow-tinged skin or eyes, fatigue and gastric issues. It causes damage to the liver, especially among those who already have liver disease.

Good hygiene to prevent the spread of hepatitis A—washing hands well after a bathroom visit and after changing diapers—lessens the chance that fecal contamination will spread the disease in those who have it. Vaccination is the best protection for those at risk.

Patrons who ate at Hardees restaurant on Little Rock Road in Charlotte between June 13 and 23 should receive a hepatitis A vaccination as soon as possible.

Public Health Director Gibbie Harris announced today that the outbreak identified by the State and Centers for Disease Control (CDC) earlier this month in Mecklenburg County has led to five additional cases since June 6, including a Hardees employee diagnosed Monday.

“After consulting with the State today, we are recommending a vaccination for exposed employees and patrons who ate at the 2604 Little Rock Road location between June 13 and 23,” Harris said. “According to the CDC, the vaccine must be given within 14 days of exposure for the vaccine to be effective.”

Public Health vaccination clinics for customers who might have been exposed and for residents who meet the high-risk factors for hepatitis A will be held:

• Wednesday, June 27 from 8 a.m. – 7.p.m, and Thursday, June 28 from 8 a.m. – 5 p.m., at Northwest Health Department, 2845 Beatties Ford Rd. and Southeast Health Department, 249 Billingsley Rd., Charlotte.
• Friday, June 29 from 3 p.m. – 8p.m. at the Hal Marshall Building, 700 N. Tryon St., Charlotte.
• Saturday, June 30 and Sunday, July 1 from 10 a.m. – 3 p.m. at the Hal Marshall Building, 700 N. Tryon St, Charlotte.

People who dined at Hardees on Little Rock Road on June 13 and 14 are strongly urged to get a vaccination in the next two days.

Public Health announced June 6 that North Carolina Public Health officials and the CDC declared an outbreak of the liver disease in Mecklenburg County. Five additional cases of hepatitis A have been identified for a total of ten confirmed cases since April 20. Those who have had a hepatitis A infection, or one hepatitis A vaccination, are protected from the virus and do not need to take action.

The high-risk factors include:

• Those who are household members, caregivers, or have sexual contact with someone who is infected with hepatitis A
• Men who have sexual encounters with other men
• Those who use recreational drugs, whether injected or not
• Recent travel from countries where hepatitis A is common
• Homeless individuals who do not have easy access to handwashing facilities

The best ways to prevent hepatitis A include:

• Get the hepatitis A vaccine;
• Practice safe handwashing procedures – wash your hands under warm, soapy water for at least 20 seconds after using the bathroom or changing diapers and before you prepare food, and
• Wear a condom during sexual activity.

Public Health staff continues to work with medical providers and community partners to educate residents about how to prevent hepatitis A and to implement a plan to educate and encourage vaccination of those most at-risk of contracting the virus.

Since 2012, hepatitis A virus cases have been on the rise across the country. Between July 2016 to November 2017, the CDC reports 1200 cases have occurred nationally, including 826 hospitalizations and 37 deaths.  Outbreaks have occurred in California, Utah, Kentucky, Michigan, Indiana, and West Virginia.

What to know about hepatitis A

1. It’s a highly contagious liver disease caused by a virus spread from person to person. The illness can last for weeks to months. Only acute cases are reportable in North Carolina.
   2. Hepatitis A spreads through the fecal-oral route, most commonly by forgetting to wash your hands after using the bathroom or changing diapers, having sexual contact with infected partners and eating or drinking foods contaminated by hepatitis A.
   3. Hepatitis A symptoms include nausea, fever, yellowing of the eyes and skin, dark urine, grey feces, joint pain, feeling tired, loss of appetite and stomach pain.
   4. The best way to prevent hepatitis A is to get the hepatitis A vaccine and to practice safe handwashing procedures – wash your hands under warm, soapy water for at least 20 seconds after using the bathroom or changing diapers and before you prepare food.
   5. Again, the most at-risk groups for hepatitis A are people who come into contact with someone who has hepatitis A, travelers to countries where hepatitis A is common, men who have sexual contact with men, people who use drugs (both injection and non-injection) and people with clotting factor disorders.

If you have potentially been exposed to hepatitis A and are unable to receive the vaccine watch for the symptoms listed above.  If you experience any of these symptoms, access medical care as soon as possible.

Hardee’s may be found at fault for allowing an employee to work while infected with HAV, for failing to properly supervise, train, or monitor their employees who prepare food for consumption, or for failing to require its food-service employees to obtain HAV immunizations.

Bill Marler, foodborne illness expert and food safety attorney, has been an avid advocate for strengthening preventative measures within the food industry. “Any exposure to hepatitis A is entirely preventable,” Marler said. “By not requiring employees to be vaccinated against the virus, Hardee’s puts itself and all of its customers at risk. Infected people typically don’t show symptoms until a few weeks after contracting hepatitis A, so they could be spreading the virus without even knowing it. However,” he continued, “Had all employees been vaccinated, Hardee’s wouldn’t have to worry about identifying HAV positive employees in the first place, and customers wouldn’t be panicking now to receive treatment.”

Exposed employees and customers are filing for damages that include wage loss, medical-related expenses, travel expenses, emotional distress, fear of harm and humiliation, and physical pain and injury.

The acute symptoms of hepatitis A are a sudden onset of flu-like symptoms about a month after the virus is contracted. Muscle aches, headaches, loss of appetite, abdominal discomfort, fever, and jaundice are all typical symptoms of the infection. Urine may turn a dark color and stool could be light or clay-colored. The illness typically lasts a few weeks, but recovery could take up to a year. Most affected individuals show complete recovery within three to six months of the onset of illness. Relapse is possible, although it is more common in children than adults.

The best protection against a hepatitis A infection is to get vaccinated. An estimated 80,000 cases of HAV occur each year, although much higher estimates have been proposed. Hepatitis A is a virus that primarily infects the liver, and an estimated 100 people die each year as a result of acute liver failure in the U.S. due to hepatitis A. However, the rate of infection has dramatically decreased since the hepatitis A vaccine was licensed and became available in the U.S. in 1995.

Because HAV is so readily transmitted, Bill Marler encourages restaurants and food handlers to adhere to strict sanitary protocols. He warns, “The virus is almost exclusively transmitted through fecal-oral contact, so it is crucial that all employees thoroughly wash their hands after using the restroom, whether they feel sick or not.” For more information about hepatitis A, please visit www.about-hepatitis.com.

272 with Hepatitis A in Kentucky – Full Report

State laboratory tests confirmed this week that five cases of the Hepatitis A virus reported in Northern Lower Michigan have officially been linked to the larger Southeast Michigan Outbreak of Hepatitis A. Four of these cases have been reported in Grand Traverse County and one in Leelanau County.

Since August 1, 2016, there have been 677 cases of Hepatitis A identified across the state, primarily in southeastern Michigan. 82% of the cases have been severe enough to lead to hospitalization. Both the Grand Traverse County Health Department and the Benzie-Leelanau Health Department are working with state officials and participating in the State’s Community Health Emergency Coordination Center (CHECC) to monitor Hepatitis A cases, as well as spread awareness about Hepatitis A in our community.

Hepatitis A can be a serious and contagious liver disease. Although not all people infected with the Hepatitis A virus experience illness, symptoms can include: nausea and vomiting, abdominal pain, feeling tired/fatigue, fever, joint pain, loss of appetite
, yellowing of the skin and eyes dark urine and 
pale-colored feces.

Hepatitis A virus often spreads by eating contaminated food or water, between sexual partners, or through close personal contact while living with an infected person. Individuals that are at a higher risk for getting the Hepatitis A virus include the following: the homeless or those living with transient housing, persons who are incarcerated, illicit drug users (both injection and non-injection drugs), persons who have sexual activities with someone infected with Hepatitis A virus, men who have sexual relations with men, and persons who have close contact, care for, or live with someone who has the Hepatitis A virus.

The Hepatitis A virus is vaccine preventable. While the vaccine is recommended as a part of the routine childhood vaccination schedule, many adults have not yet been vaccinated. “We recommend that everyone be vaccinated against Hepatitis A,” said Wendy Hirschenberger, Health Officer for Grand Traverse County Health Department. The best way to reduce the risk of getting Hepatitis A is to get vaccinated. It is also recommended to regularly wash your hands after using the bathroom and before preparing meals for yourself and others. In addition, don’t share toothbrushes or eating utensils, do not have sex with someone who has a Hepatitis A infection, and do not share food and/or drinks with other people.

Individuals who believe they have been exposed to Hepatitis A or who have symptoms consistent with the virus, should contact their healthcare provider immediately. Anyone who wants to be vaccinated should contact their healthcare provider or their local health department: Benzie-Leelanau Health Department at 231-256-0200 Grand Traverse County Health Department at 231-995-6131 Health Department of Northwest Michigan 800-432-4121

The confirmation of five cases of Hepatitis A in northern Michigan has prompted the Grand Traverse County Health Department to host special clinic hours to offer vaccinations to the community today (Saturday) from 10am to 1pm at the department’s offices at 2600 LaFranier Road.

The vaccination will be offered to individuals with or without insurance; those who can’t afford the vaccination or don’t have insurance can receive it for free. Hepatitis A is a serious, highly contagious liver disease caused by the Hepatitis A virus (HAV). The virus can be spread through contaminated food or water, sexual contact, or by living with an infected person. The illness can appear 15-50 days after exposure and last for several weeks. In some cases, Hepatitis A can be fatal.

Other upcoming extended clinic walk-in hours for vaccinations at the Grand Traverse County Health Department include:

Wednesday, February 21: 4:30pm-6:30pm
Wednesday, February 28: 7am-8am
Wednesday, March 7: 4:30pm-6:30pm
Wednesday, March 14: 7am-8am
Wednesday, March 21: 4:30pm-6:30pm
Wednesday, March 28: 7am-8am

The Wyoming Department of Health (WDH) and the Casper-Natrona County Health Department continue to investigate a growing Natrona County hepatitis A outbreak that began in October.

Since October, 14 cases have been confirmed among Natrona County residents, which is a significant increase over the usual total for Wyoming. Previously, the long-term average statewide was two cases annually with the last reported local Hepatitis A infection in 2012.

“While some of the Natrona County cases did not have a clear hepatitis A exposure risk, recent cases have been concentrated among current injection drug users,” said Clay Van Houten, Infectious Disease Epidemiology Program manager with WDH.

Infection with hepatitis A typically results in symptoms in older children and adults.

Symptoms usually occur abruptly and include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored stools, joint pain and jaundice.

There can be a significant delay between when someone who is exposed to the virus and when they show symptoms.

“People recently exposed to hepatitis A who have not been vaccinated should receive a vaccine as soon as possible,” Van Houten said.

Specific risk factors for hepatitis A include:

• Persons with direct contact with a person who has hepatitis A
• Men who have sex with men
• Users of injection and non-injection drugs
• Travelers to countries with high rates of hepatitis A infectionHepatitis A can cause infection in the liver. The virus is primarily spread person-to-person through oral contact with contaminated items such as swallowing food or drink tainted with a tiny amount infected feces.

Van Houten said the best way to prevent hepatitis A is through vaccination.

Handwashing, especially after using the bathroom, changing diapers, and before preparing or eating food, plays an important role in preventing the spread of the virus.

Vaccination to prevent hepatitis A is routinely recommended.

Children aged at least 12 months and less than 24 months should receive two doses of the vaccine separated by at least 6 months and no less than 18 months.

The vaccine series is also recommended for people aged 2 years or older who have not already received it.

The Casper-Natrona County Health Department offers the hepatitis A series vaccine; some people may qualify for free or discounted vaccine.